title: Endonasal repositioning of the upper lateral cartilage and the internal nasal valve.
abstract: OBJECTIVE
  Collapse of the upper lateral cartilage (ULC) is associated with narrowing of the internal nasal valve (INV). The goal of this article is to describe a novel procedure that repositions the ULC, opening the INV, without implants, grafts, or permanent sutures.
  
  
  METHODS
  Before-and-after digital photographs of patients with ULC and INV collapse who underwent endonasal ULC repositioning were analyzed. The surgical procedure consists of an intercartilaginous incision and the creation of a surface that permits scarification upon cartilage reapproximation. Precise placement of a support apparatus permits the ULC to heal into a position in direct contact with the lower lateral cartilage,thus dilating the INV. The percentage of collapse of the ULC (PCULC), determined by ULC shape measurements made with computer-aided design software, was compared on before-and-after photographs by use of Student's t-test (paired).
  
  
  RESULTS
  The study included 52 patients (79 procedures) followed for 1 to 18 months after surgery in the period 2007 to 2009. There were no complications or revision surgeries. The preoperative mean PCULC was 58.6%. The postoperative mean PCULC was 5.7% (p < 0.0001).
  
  
  CONCLUSIONS
  Repair of the INV via ULC repositioning is a simple, relatively safe procedure that produces a statistically significant improvement in the PCULC. The functional change at the INV may be inferred from the ULC shape, but further prospective clinical studies are required.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Stupak
mesh_terms: D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery*; D009296:Nasal Cavity / Q000601:surgery*; D015508:Nasal Obstruction / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods